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<br /> r . , , 3472br
<br /> Registration and Fees Location and Parking
<br /> ` Minnesota
<br /> The fee forthe Institute is $320 which The Institute will be held at the Earle t i Municipal Clerks
<br /> includes instruction, course materials, Brown Continuing Education Center, I Institute
<br /> breakfast, lunches, refreshment 1890 Buford Avenue, on the St. Paul
<br /> breaks, and Thursday banquet. campus of the University of Minnesota.
<br /> Application for registration should be Ample parking is available in the lot July 15- 19,1996
<br /> made on the attached form and mailed adjacentto the Earle Brown Center for
<br /> to the University of Minnesota. $2.75 per day. A map showing the Name
<br /> Applications accompanied by the location of the Earle Brown Center and First M.1. Cast
<br /> full fee must be received by July B, parking lots will be mailed with
<br /> 1996. A refund of the registration fee confirmation of registration. Social Security No.
<br /> will be made if written cancellation is (or s
<br /> received by July 10; a $15 service fee Continuing Education Units
<br /> will be charged on all cancellations. Employer
<br /> The University reserves the rightto This Institute carries 3.4 Continuing
<br /> cancel the Institute if necessary. Education Units (CEUs). One CEU is
<br /> Disability accommodations will be defined as 10 contact hours of Work Address
<br /> provided upon request. participation in an organized continu- Street
<br /> ing education experience under
<br /> Accommodations responsible sponsorship, capable City State Zip Code
<br /> direction, and qualified instruction.
<br /> A block of sleeping rooms for out -ol
<br /> town participants has been reserved For Further Information Telephone Position
<br /> at the Sheraton Midway Hotel, 400
<br /> North Hamline, St. Paul, Minnesota Richard Grefe (612) 625 -0196 or Bev ❑ Year 1 (W1) ❑ Year 2 (W2) ❑ Year 3 (W3)
<br /> 55104, phone (612) 642 -1234. Room Ringsak (612) 625 -6689, University of ❑ 01 $320 fee enclosed payable to University of Minnesota.
<br /> rates are $62 single or double Minnesota, Professional Development ❑ I've enclosed $ 25 for a guest ticket to the Thursday evening banquet.
<br /> occupancy. Please make your and Conference Services, 206 Nolte ❑ Purchase order or letter of authorization to bill employer is enclosed.
<br /> reservation directly with the hotel using Center, 315 Pillsbury Drive S.E., (Required if billing is requested)
<br /> the form enclosed. Reservations must Minneapolis, MN 55455 -0139. ❑ Charge the Institute fee to
<br /> be received by the Sheraton Midway FAX: (612) 626 -1632. ❑VISA ❑MasterCard ❑Discover ❑American Express
<br /> before July 1, 1996, to guarantee
<br /> [ Account No. Expiration Date
<br /> accommodations. Reservations
<br /> The University of Minnesota is
<br /> received after this date will be handled committed to the policy that ail ' Printed name of account holder
<br /> onafirst -come, first -served basis. It persons shall have equalaccess to its
<br /> you call in the reservation, be sure to programs, facilities, and employment Signature of account holder
<br /> mention your participation in the without regard to race, color, creed, The information on this form is private data,
<br /> Institute to receive special rates. religion, national origin, sex, age, Mail to: used to identify and locate you, obtain
<br /> marital status, disability, public MAIL to: 3472 Registrar, payment, and enable instructors to better
<br /> know assistance status, or sexual orienta- University f Minnesota, payment m eth d are Name,ad d
<br /> y payment method are mandatory. If you desire
<br /> tion. PDCS, 235 Nolte Center, CEU certification and do notsupplya Social
<br /> 315 Pillsbury Drive S.E., Security number, an alternative identifier will
<br /> Minneapolis, MN 55455 -0139 be used. Information on this term, except
<br /> Social Security number, may be shared wish
<br />
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